原发性高血压患者颈动脉硬化与炎症因子及血脂的相关性

【目的】探讨原发性高血压患者颈动脉硬化与炎症因子及血脂的相关性。【方法】选取原发性高血压患者91例及血压正常者42例，应用彩色多普勒超声检测颈动脉内膜-中层厚度（IMT）及斑块情况，根据颈动脉超声检测结果将高血压组分为伴颈动脉硬化组（IMT≥0．9mm）40例和无颈动脉硬化组（IMT〈0．9mm）51例。测定超敏c反应蛋白（hsCRP）、白细胞介素1（IL-1）、肿瘤坏死因子-α（TNF—α）及血脂。【结果】①高血压组收缩压、舒张压、TC、LDL-C及颈动脉斑块发生率明显高于对照组（P〈0．05），②高血压组hs—CRP、IL—1、TNFa、颈动脉IMT值均明显高于对照组，且高血压患者中颈动脉硬化组hs—CRP、IL-1、TNF-α、颈动脉IMT值均明显高于无颈动脉硬化组（P〈O．05），③在高血压患者，颈动脉IMT与hs—CRP（r=0．426；P〈0．05）、IL-1（r=0．327；P〈0．05）、TNF-α（r=0．284；P〈0．05）呈正相关。多元逐步回归分析表明：在高血压患者中，收缩压、hsCRP及LDL-C是影响高血压患者颈动脉IMT增厚的主要危险因素。【结论】高血压患者颈动脉硬化的形成与血压增高、炎症因子及血脂异常有关。

Association Between Carotid Atherosclerosis and Inflammatory Factors,Serum Lipids in Patients with Essential Hypertension

Objective]To investigate the association between carotid atherosclerosis and inflammatory factors, serum lipids in patients with essential hypertension（EH）. Methods]A total of 91 patients with EH（EH group） and 42 healthy subjects（control group） were selected. The intima-media thickness（IMT） and plaque of common carotid arteries were measured in all patients by color Doppler ultrasound. According to the results of carotid artery ultrasound, EH group were divided into carotid arteriosclerosis group（IMT≥0.9mm, n =40） and non carotid arteriosclerosis group（IMT〈0.9mm, n = 51）. High-sensitivity C reactive protein（hs CRP）, interleukin-1（IL-1）, tumor necrosis factor （TNF-α） and serum lipids were measured. Results] Systolic blood pressure（SBP）, diastolic blood pressure（DBP）, total cholesterol（TC）, low density lipoprotein eholesterol（LDL C） and the incidence of plaque in carotid artery in EH group were obviously higher than those in control group（ P〈0.05）. hs CRP, IL-1, TNF-α and carotid IMT in EH group were significantly higher than those in control group, and those in carotid arteriosclerosis group in EH patients were obviously higher than those in non carotid arteriosclerosis group（ P G0.05）. In EH patients, carotid IMT had positive correlation with the levels of hs-CRP（r=0.426; P 〈0.05）, IL-1（r=0.327; P〈0.05）and TNF-α（r=0. 284; P 〈 0.05）. Multiple stepwise regression showed that SBP, hs-CRP and LDL-C in EH patients were the main risk factors of the thickening of carotid IMT. Conclusion] The development of carotid arteriosclerosis in EH patients is associated with the increased blood pressure, inflammatory factors and disorders of serum lipids.